const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Diabetes Mellitus";
pres.author = "Orris Medical";

// ─── COLOUR PALETTE ───────────────────────────────────────────────────────────
const DARK_BG   = "0D2137";   // deep navy  (title / section dividers)
const MID_BG    = "103455";   // mid navy   (accent headers)
const LIGHT_BG  = "EBF4FB";   // pale blue  (content bg)
const ACCENT    = "1A8FE3";   // vivid blue (highlight bars, icons)
const WHITE     = "FFFFFF";
const BODY_TEXT = "1C2B3A";
const MUTED     = "4A6580";

// ─── HELPER: section header bar ───────────────────────────────────────────────
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    fontSize: 22, bold: true, color: WHITE, valign: "middle", margin: 0,
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}

// ─── HELPER: accent side-bar ──────────────────────────────────────────────────
function addSideBar(slide, color = ACCENT) {
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}

// ─── SLIDE 1: TITLE ───────────────────────────────────────────────────────────
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  s.background = { color: DARK_BG };

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  s.addText("DIABETES MELLITUS", {
    x: 0.6, y: 1.4, w: 8.8, h: 1.2,
    fontSize: 46, bold: true, color: WHITE, align: "center", charSpacing: 4,
  });
  s.addText("Types · Pathophysiology · Treatment", {
    x: 0.6, y: 2.75, w: 8.8, h: 0.7,
    fontSize: 22, color: ACCENT, align: "center", italic: true,
  });
  s.addText("A comprehensive clinical overview", {
    x: 0.6, y: 3.55, w: 8.8, h: 0.5,
    fontSize: 14, color: "8BB8D4", align: "center",
  });
  s.addText("Source: Textbook of Family Medicine 9e  |  Washington Manual of Medical Therapeutics", {
    x: 0.6, y: 5.0, w: 8.8, h: 0.35,
    fontSize: 10, color: "607D8B", align: "center",
  });
}

// ─── SLIDE 2: OVERVIEW ────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.background = { color: LIGHT_BG };
  addSideBar(s);
  addHeader(s, "What is Diabetes Mellitus?");

  const bullets = [
    "Diabetes mellitus (DM) is a group of metabolic diseases characterised by chronic hyperglycaemia.",
    "Results from defects in insulin secretion, insulin action, or both.",
    "~25.8 million Americans have DM; 79 million have pre-diabetes.",
    "~1.9 million new cases diagnosed annually in adults aged ≥20 years.",
    "WHO projects >350 million people worldwide will have DM by 2025.",
    "Nearly 80 % of people with DM will die of cardiovascular disease (CVD) complications.",
    "DM is classified as a CAD risk equivalent by the NCEP.",
  ];

  s.addText(bullets.map((t, i) => ({
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    options: { bullet: { type: "bullet", code: "2022" }, breakLine: i < bullets.length - 1, paraSpaceAfter: 4 },
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    x: 0.55, y: 0.85, w: 9.1, h: 4.5,
    fontSize: 14, color: BODY_TEXT, lineSpacingMultiple: 1.25,
  });
}

// ─── SLIDE 3: CLASSIFICATION ──────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.background = { color: LIGHT_BG };
  addSideBar(s);
  addHeader(s, "Classification of Diabetes Mellitus");

  const types = [
    { label: "Type 1 DM", color: "C0392B", text: "Autoimmune destruction of β-cells → absolute insulin deficiency. Requires lifelong insulin therapy. Previously called IDDM." },
    { label: "Type 2 DM", color: "1A8FE3", text: "Progressive insulin secretory defect on a background of insulin resistance. ~90–95 % of all adult DM. Strongly linked to obesity." },
    { label: "Gestational DM", color: "27AE60", text: "Glucose intolerance first recognised during pregnancy. Increases maternal and foetal risk." },
    { label: "Other Specific Types", color: "8E44AD", text: "MODY (monogenic), drug-induced (steroids, antipsychotics), diseases of exocrine pancreas (pancreatitis, CF), endocrinopathies (Cushing's, acromegaly)." },
  ];

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    s.addText(t.text, { x: 2.75, y: y + 0.08, w: 6.75, h: 0.78, fontSize: 12, color: BODY_TEXT, valign: "middle" });
  });
}

// ─── SLIDE 4: TYPE 1 DM ───────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.background = { color: LIGHT_BG };
  addSideBar(s, "C0392B");
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.72, fill: { color: "C0392B" } });
  s.addText("Type 1 Diabetes Mellitus (T1DM)", {
    x: 0.38, y: 0, w: 9.24, h: 0.72,
    fontSize: 22, bold: true, color: WHITE, valign: "middle", margin: 0,
  });

  const left = [
    { hdr: "Aetiology", body: "T-cell mediated autoimmune destruction of pancreatic β-cells. Associated with HLA-DR3 and HLA-DR4." },
    { hdr: "Onset", body: "Usually childhood/adolescence; can occur at any age." },
    { hdr: "Pathophysiology", body: "Complete or near-complete insulin deficiency → hyperglycaemia, ketogenesis, DKA if untreated." },
    { hdr: "Classic Symptoms", body: "Polyuria, polydipsia, polyphagia, weight loss, fatigue, blurred vision." },
  ];

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    s.addText(item.hdr, { x: 0.3, y, w: 4.5, h: 0.32, fontSize: 13, bold: true, color: "C0392B", margin: 0 });
    s.addText(item.body, { x: 0.3, y: y + 0.30, w: 4.5, h: 0.72, fontSize: 12, color: BODY_TEXT });
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  // right panel
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  s.addText("Key Diagnostics", { x: 5.2, y: 0.88, w: 4.4, h: 0.38, fontSize: 14, bold: true, color: "C0392B" });
  const diag = [
    "Fasting plasma glucose ≥ 126 mg/dL",
    "2-hr glucose ≥ 200 mg/dL (OGTT)",
    "HbA1c ≥ 6.5 %",
    "Random glucose ≥ 200 mg/dL + symptoms",
    "Positive islet-cell / anti-GAD antibodies",
    "C-peptide low or undetectable",
  ];
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}

// ─── SLIDE 5: TYPE 2 DM ───────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.background = { color: LIGHT_BG };
  addSideBar(s, ACCENT);
  addHeader(s, "Type 2 Diabetes Mellitus (T2DM)");

  // Two columns
  const colA = [
    { hdr: "Insulin Resistance", body: "Target tissues (muscle, liver, fat) fail to respond normally to insulin. Compensatory hyperinsulinaemia follows." },
    { hdr: "β-cell Failure", body: "Progressive decline in β-cell mass and function → relative insulin deficiency over time." },
    { hdr: "Risk Factors", body: "Obesity (central adiposity), physical inactivity, family history, age >45, ethnicity, hypertension, dyslipidaemia, prior GDM." },
  ];
  const colB = [
    { hdr: "Ominous Octet", body: "Liver ↑ glucose output, muscle ↓ uptake, fat ↑ lipolysis, GI ↓ incretins, α-cells ↑ glucagon, kidney ↑ glucose reabsorption, brain neurotransmitter dysregulation, β-cells ↓ secretion." },
    { hdr: "Macrovascular Complications", body: "MI, stroke, PAD. DM = CAD risk equivalent. Atherosclerosis accelerated by hyperglycaemia, oxidative stress, AGEs." },
    { hdr: "Microvascular Complications", body: "Nephropathy, retinopathy, neuropathy. Every 1 % drop in HbA1c → 37 % reduction in microvascular risk (UKPDS 35)." },
  ];

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    const y = 0.9 + i * 1.55;
    s.addText(item.hdr, { x: 0.3, y, w: 4.6, h: 0.3, fontSize: 13, bold: true, color: ACCENT, margin: 0 });
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  colB.forEach((item, i) => {
    const y = 0.9 + i * 1.55;
    s.addText(item.hdr, { x: 5.2, y, w: 4.6, h: 0.3, fontSize: 13, bold: true, color: MID_BG, margin: 0 });
    s.addText(item.body, { x: 5.2, y: y + 0.28, w: 4.6, h: 1.1, fontSize: 12, color: BODY_TEXT });
  });
  // divider
  s.addShape(pres.ShapeType.line, { x: 5.0, y: 0.85, w: 0, h: 4.5, line: { color: ACCENT, width: 1, dashType: "sysDash" } });
}

// ─── SLIDE 6: GESTATIONAL & OTHER ─────────────────────────────────────────────
{
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  s.background = { color: LIGHT_BG };
  addSideBar(s, "27AE60");
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.72, fill: { color: "27AE60" } });
  s.addText("Gestational DM & Other Specific Types", {
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    fontSize: 22, bold: true, color: WHITE, valign: "middle", margin: 0,
  });

  // GDM box
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  s.addText("Gestational DM (GDM)", { x: 0.4, y: 0.95, w: 4.3, h: 0.38, fontSize: 14, bold: true, color: "27AE60" });
  const gdm = [
    "Glucose intolerance first detected in pregnancy",
    "Screening: 24–28 weeks gestation with OGTT",
    "Risks: macrosomia, neonatal hypoglycaemia, pre-eclampsia",
    "Management: diet, exercise, insulin if targets not met",
    "50 % lifetime risk of developing T2DM post-partum",
  ];
  s.addText(gdm.map((d, i) => ({
    text: d,
    options: { bullet: { type: "bullet" }, breakLine: i < gdm.length - 1, paraSpaceAfter: 4 },
  })), { x: 0.4, y: 1.4, w: 4.3, h: 3.8, fontSize: 12, color: BODY_TEXT });

  // Other types box
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  s.addText("Other Specific Types", { x: 5.2, y: 0.95, w: 4.4, h: 0.38, fontSize: 14, bold: true, color: "8E44AD" });
  const other = [
    "MODY (1–6): single-gene defects in β-cell function",
    "Pancreatogenic: chronic pancreatitis, cystic fibrosis, pancreatectomy",
    "Endocrinopathies: Cushing's syndrome, acromegaly, phaeochromocytoma",
    "Drug/chemical-induced: glucocorticoids, thiazides, antipsychotics, tacrolimus",
    "Infections: congenital rubella, CMV",
    "Rare immune-mediated: stiff-man syndrome, anti-insulin receptor antibodies",
  ];
  s.addText(other.map((d, i) => ({
    text: d,
    options: { bullet: { type: "bullet" }, breakLine: i < other.length - 1, paraSpaceAfter: 4 },
  })), { x: 5.2, y: 1.4, w: 4.4, h: 3.8, fontSize: 12, color: BODY_TEXT });
}

// ─── SLIDE 7: DIAGNOSIS ───────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.background = { color: LIGHT_BG };
  addSideBar(s);
  addHeader(s, "Diagnosis & Glycaemic Targets");

  const criteria = [
    ["Test", "Normal", "Pre-diabetes", "Diabetes"],
    ["Fasting Plasma Glucose", "< 100 mg/dL", "100–125 mg/dL", "≥ 126 mg/dL"],
    ["2-hr OGTT (75 g)", "< 140 mg/dL", "140–199 mg/dL", "≥ 200 mg/dL"],
    ["HbA1c", "< 5.7 %", "5.7–6.4 %", "≥ 6.5 %"],
    ["Random Glucose + Sx", "—", "—", "≥ 200 mg/dL"],
  ];

  s.addTable(criteria, {
    x: 0.4, y: 0.85, w: 9.2, h: 2.9,
    colW: [2.4, 1.9, 1.9, 1.9],
    fontFace: "Calibri",
    fontSize: 12,
    align: "center",
    border: { pt: 1, color: "C5D8EA" },
    fill: WHITE,
    color: BODY_TEXT,
    autoPage: false,
    rowH: 0.52,
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  // Colour header row by overriding with a rect
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  s.addText(["Test", "Normal", "Pre-diabetes", "Diabetes"].map((t, i) => ({
    text: t,
    options: { breakLine: false },
  })).reduce((acc, cur, i, arr) => {
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    x: 0.4, y: 0.85, w: 9.2, h: 0.52,
    fontSize: 13, bold: true, color: WHITE, align: "center", valign: "middle",
  });

  s.addText("Glycaemic Targets (ADA / ACE)", { x: 0.4, y: 3.92, w: 9.2, h: 0.38, fontSize: 14, bold: true, color: MID_BG });
  const targets = [
    "HbA1c < 7.0 % (ADA)  |  < 6.5 % (ACE) — tighter control if tolerated without hypoglycaemia",
    "Fasting glucose: 80–130 mg/dL  |  Peak post-prandial glucose < 180 mg/dL",
    "Every 1 % reduction in HbA1c → 21 % reduction in any DM-related endpoint (UKPDS 35)",
    "Blood pressure < 130/80 mmHg; LDL-C < 100 mg/dL (< 70 mg/dL if CVD present)",
  ];
  s.addText(targets.map((d, i) => ({
    text: d,
    options: { bullet: { type: "bullet" }, breakLine: i < targets.length - 1, paraSpaceAfter: 3 },
  })), { x: 0.4, y: 4.35, w: 9.2, h: 1.15, fontSize: 12, color: BODY_TEXT });
}

// ─── SLIDE 8: T1DM TREATMENT ──────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.background = { color: LIGHT_BG };
  addSideBar(s, "C0392B");
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.72, fill: { color: "C0392B" } });
  s.addText("Treatment: Type 1 DM — Insulin Therapy", {
    x: 0.38, y: 0, w: 9.24, h: 0.72,
    fontSize: 22, bold: true, color: WHITE, valign: "middle", margin: 0,
  });

  const insulins = [
    ["Insulin Type", "Onset", "Peak", "Duration", "Example"],
    ["Rapid-acting", "5–15 min", "30–90 min", "3–5 hr", "Lispro, Aspart, Glulisine"],
    ["Short-acting", "30–60 min", "2–4 hr", "6–8 hr", "Regular (Humulin R)"],
    ["Intermediate", "1–3 hr", "4–10 hr", "12–18 hr", "NPH (Humulin N)"],
    ["Long-acting", "1–2 hr", "No peak", "20–24 hr", "Glargine, Detemir"],
    ["Ultra-long", "~6 hr", "No peak", ">36 hr", "Degludec"],
  ];

  s.addTable(insulins, {
    x: 0.3, y: 0.85, w: 9.4, h: 3.0,
    colW: [1.85, 1.35, 1.35, 1.35, 3.5],
    fontSize: 11,
    fontFace: "Calibri",
    align: "center",
    border: { pt: 1, color: "EECFCF" },
    fill: WHITE,
    color: BODY_TEXT,
    rowH: 0.44,
  });

  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 0.85, w: 9.4, h: 0.44, fill: { color: "C0392B" } });
  s.addText("Insulin Type       Onset       Peak       Duration       Example", {
    x: 0.3, y: 0.85, w: 9.4, h: 0.44,
    fontSize: 12, bold: true, color: WHITE, align: "center", valign: "middle",
  });

  const notes = [
    "Basal–bolus regimen is standard of care: long-acting basal + rapid-acting bolus at meals.",
    "Continuous glucose monitoring (CGM) + insulin pump (CSII) improves outcomes.",
    "DCCT trial: intensive glycaemic control reduces microvascular complications by 40–70 %.",
    "Prevent DKA: never omit basal insulin; sick-day rules essential.",
  ];
  s.addText(notes.map((d, i) => ({
    text: d,
    options: { bullet: { type: "bullet" }, breakLine: i < notes.length - 1, paraSpaceAfter: 3 },
  })), { x: 0.3, y: 4.0, w: 9.4, h: 1.45, fontSize: 12, color: BODY_TEXT });
}

// ─── SLIDE 9: T2DM TREATMENT – OAD ────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.background = { color: LIGHT_BG };
  addSideBar(s, ACCENT);
  addHeader(s, "Treatment: Type 2 DM — Oral & Non-Insulin Agents");

  const drugs = [
    { cls: "Biguanides", eg: "Metformin", moa: "↓ hepatic glucose output, ↑ insulin sensitivity", notes: "1st-line; cardioprotective (UKPDS: −38 % CV events); hold if eGFR <30" },
    { cls: "Sulfonylureas", eg: "Glipizide, Glimepiride", moa: "↑ insulin secretion (KATP closure)", notes: "Risk of hypoglycaemia & weight gain; avoid in renal failure" },
    { cls: "SGLT-2 inhibitors", eg: "Empagliflozin, Dapagliflozin", moa: "↑ urinary glucose excretion", notes: "CV & renal protective; weight loss; risk of genital infections, DKA" },
    { cls: "GLP-1 agonists", eg: "Semaglutide, Liraglutide", moa: "↑ insulin, ↓ glucagon, ↓ appetite (incretin-based)", notes: "CV benefit; significant weight loss; GI side effects; injectable" },
    { cls: "DPP-4 inhibitors", eg: "Sitagliptin, Saxagliptin", moa: "↑ endogenous GLP-1 / GIP (incretin-based)", notes: "Weight neutral; well tolerated; modest HbA1c reduction" },
    { cls: "TZDs", eg: "Pioglitazone", moa: "PPAR-γ agonist → ↑ insulin sensitivity", notes: "Fluid retention, weight gain, risk of HF and fractures" },
    { cls: "Alpha-glucosidase inhibitors", eg: "Acarbose", moa: "↓ carbohydrate absorption in gut", notes: "GI side effects (flatulence, diarrhoea); modest efficacy" },
  ];

  drugs.forEach((d, i) => {
    const y = 0.85 + i * 0.67;
    const bg = i % 2 === 0 ? WHITE : "F0F7FF";
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    s.addText(d.cls, { x: 0.35, y: y + 0.06, w: 2.0, h: 0.5, fontSize: 11, bold: true, color: MID_BG, valign: "middle" });
    s.addText(d.eg,  { x: 2.4,  y: y + 0.06, w: 1.8, h: 0.5, fontSize: 10, italic: true, color: MUTED, valign: "middle" });
    s.addText(d.moa, { x: 4.25, y: y + 0.06, w: 2.5, h: 0.5, fontSize: 10, color: BODY_TEXT, valign: "middle" });
    s.addText(d.notes,{ x: 6.8, y: y + 0.06, w: 2.85, h: 0.5, fontSize: 10, color: BODY_TEXT, valign: "middle" });
  });

  // column headers
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 0.85, w: 9.4, h: 0.42, fill: { color: MID_BG } });
  ["Drug Class", "Example(s)", "Mechanism", "Key Notes"].forEach((h, i) => {
    const xs = [0.35, 2.4, 4.25, 6.8];
    const ws = [2.0, 1.8, 2.5, 2.85];
    s.addText(h, { x: xs[i], y: 0.85, w: ws[i], h: 0.42, fontSize: 11, bold: true, color: WHITE, valign: "middle", margin: 0 });
  });
}

// ─── SLIDE 10: T2DM TREATMENT – LIFESTYLE & ALGORITHM ─────────────────────────
{
  const s = pres.addSlide();
  s.background = { color: LIGHT_BG };
  addSideBar(s, ACCENT);
  addHeader(s, "Treatment Algorithm & Lifestyle Management");

  // Step boxes
  const steps = [
    { n: "1", label: "Lifestyle Modification", detail: "Medical nutrition therapy · ≥150 min/week moderate exercise · weight loss 5–10 % · smoking cessation", color: "27AE60" },
    { n: "2", label: "Metformin (if tolerated)", detail: "Start alongside lifestyle changes at diagnosis. Target HbA1c < 7 %. Titrate over 4–8 weeks.", color: ACCENT },
    { n: "3", label: "Add 2nd Agent", detail: "Choose based on CVD/renal status:\n• CVD present → SGLT-2i or GLP-1 RA\n• HF/CKD → SGLT-2i preferred\n• Weight concern → GLP-1 RA or SGLT-2i\n• Hypoglycaemia risk → DPP-4i or TZD", color: "E67E22" },
    { n: "4", label: "Add 3rd Agent or Insulin", detail: "Triple oral therapy or initiate basal insulin (10 units/night or 0.1–0.2 U/kg). Intensify to basal–bolus if needed.", color: "C0392B" },
  ];

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    s.addShape(pres.ShapeType.rect, { x: 0.3, y, w: 0.65, h: 1.05, fill: { color: step.color } });
    s.addText(step.n, { x: 0.3, y, w: 0.65, h: 1.05, fontSize: 24, bold: true, color: WHITE, align: "center", valign: "middle", margin: 0 });
    s.addText(step.label, { x: 1.05, y: y + 0.05, w: 3.0, h: 0.38, fontSize: 13, bold: true, color: step.color, margin: 0 });
    s.addText(step.detail, { x: 1.05, y: y + 0.42, w: 8.5, h: 0.58, fontSize: 11, color: BODY_TEXT });
  });
}

// ─── SLIDE 11: COMPLICATIONS ──────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.background = { color: LIGHT_BG };
  addSideBar(s);
  addHeader(s, "Complications of Diabetes Mellitus");

  // Acute
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 0.85, w: 4.5, h: 4.55, fill: { color: "FFF8E1" }, line: { color: "F39C12", width: 2 } });
  s.addText("ACUTE", { x: 0.4, y: 0.92, w: 4.3, h: 0.36, fontSize: 14, bold: true, color: "E67E22" });
  const acute = [
    "DKA (T1DM): ketones, pH <7.3, anion-gap acidosis",
    "HHS (T2DM): extreme hyperglycaemia >600 mg/dL, hyperosmolarity, no ketosis",
    "Hypoglycaemia: BG <70 mg/dL — tremor, diaphoresis, confusion",
    "Hypoglycaemia unawareness: especially with tight control",
  ];
  s.addText(acute.map((d, i) => ({
    text: d,
    options: { bullet: { type: "bullet" }, breakLine: i < acute.length - 1, paraSpaceAfter: 5 },
  })), { x: 0.4, y: 1.35, w: 4.3, h: 3.8, fontSize: 12, color: BODY_TEXT });

  // Chronic
  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 0.85, w: 4.6, h: 4.55, fill: { color: "EBF5FB" }, line: { color: ACCENT, width: 2 } });
  s.addText("CHRONIC", { x: 5.2, y: 0.92, w: 4.4, h: 0.36, fontSize: 14, bold: true, color: MID_BG });
  const chronic = [
    "Macrovascular: CAD, stroke, peripheral arterial disease",
    "Diabetic nephropathy: leading cause of ESRD; screen with urine albumin",
    "Diabetic retinopathy: leading cause of blindness in working age adults",
    "Diabetic neuropathy: peripheral (stocking-glove), autonomic",
    "Diabetic foot: ulcers, Charcot arthropathy, amputation risk",
    "Increased infection risk: UTI, cellulitis, TB, candidiasis",
  ];
  s.addText(chronic.map((d, i) => ({
    text: d,
    options: { bullet: { type: "bullet" }, breakLine: i < chronic.length - 1, paraSpaceAfter: 4 },
  })), { x: 5.2, y: 1.35, w: 4.4, h: 3.8, fontSize: 12, color: BODY_TEXT });
}

// ─── SLIDE 12: MONITORING & FOLLOW-UP ─────────────────────────────────────────
{
  const s = pres.addSlide();
  s.background = { color: LIGHT_BG };
  addSideBar(s);
  addHeader(s, "Monitoring & Preventive Care");

  const items = [
    { icon: "HbA1c", freq: "Every 3 months", detail: "Target < 7.0 % (ADA) or < 6.5 % (ACE)" },
    { icon: "BP", freq: "Every visit", detail: "Target < 130/80 mmHg; ACE-I or ARB preferred (renoprotective)" },
    { icon: "Lipids", freq: "Annually", detail: "Statin therapy for all adults with DM (high-intensity if CVD)" },
    { icon: "Urine Albumin", freq: "Annually", detail: "ACR; ACE-I/ARB if microalbuminuria detected (≥30 mg/g)" },
    { icon: "Eye Exam", freq: "Annually", detail: "Dilated fundoscopy; refer to ophthalmology" },
    { icon: "Foot Exam", freq: "Every visit", detail: "Monofilament, vibration, pulses; preventive podiatry care" },
    { icon: "Vaccinations", freq: "Per schedule", detail: "Influenza annually; pneumococcal; Hepatitis B series" },
    { icon: "Aspirin", freq: "Daily", detail: "75–162 mg/day if 10-yr CVD risk > 10 % or established CVD" },
  ];

  items.forEach((item, i) => {
    const col = i < 4 ? 0 : 1;
    const row = i % 4;
    const x = col === 0 ? 0.3 : 5.1;
    const y = 0.88 + row * 1.12;
    const colors = ["1A8FE3","27AE60","E67E22","8E44AD","C0392B","1A8FE3","27AE60","E67E22"];
    s.addShape(pres.ShapeType.rect, { x, y, w: 4.5, h: 1.0, fill: { color: WHITE }, line: { color: colors[i], width: 1.5 } });
    s.addShape(pres.ShapeType.rect, { x, y, w: 1.2, h: 1.0, fill: { color: colors[i] } });
    s.addText(item.icon, { x, y, w: 1.2, h: 1.0, fontSize: 10, bold: true, color: WHITE, align: "center", valign: "middle", margin: 0 });
    s.addText(item.freq, { x: x + 1.28, y: y + 0.06, w: 3.1, h: 0.3, fontSize: 11, bold: true, color: colors[i], margin: 0 });
    s.addText(item.detail, { x: x + 1.28, y: y + 0.36, w: 3.1, h: 0.55, fontSize: 10, color: BODY_TEXT });
  });
}

// ─── SLIDE 13: KEY TAKEAWAYS ──────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.background = { color: DARK_BG };

  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.18, fill: { color: ACCENT } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 5.445, w: 10, h: 0.18, fill: { color: ACCENT } });

  s.addText("Key Takeaways", {
    x: 0.5, y: 0.3, w: 9, h: 0.65,
    fontSize: 28, bold: true, color: WHITE, align: "center",
  });

  const takes = [
    "DM is a heterogeneous metabolic disorder — classify correctly (T1/T2/GDM/Other) before selecting therapy.",
    "Type 1 DM requires lifelong insulin. Basal–bolus regimens and CGM are standard of care.",
    "Type 2 DM treatment is stepwise: lifestyle → Metformin → add cardio/renally protective agent → insulin.",
    "SGLT-2 inhibitors and GLP-1 agonists provide independent cardiovascular and renal benefits beyond glucose control.",
    "Tight control (HbA1c < 7 %) reduces microvascular risk; balance against hypoglycaemia risk.",
    "Every 1 % fall in HbA1c cuts microvascular risk by 37 % and any DM endpoint by 21 % (UKPDS 35).",
    "Multifactorial risk reduction (glucose + BP + lipids + aspirin) is mandatory — STRATOS-2 showed 50 % ↓ in CV events.",
  ];

  takes.forEach((t, i) => {
    const y = 1.1 + i * 0.61;
    s.addShape(pres.ShapeType.rect, { x: 0.45, y: y + 0.08, w: 0.35, h: 0.35, fill: { color: ACCENT } });
    s.addText(`${i + 1}`, { x: 0.45, y: y + 0.08, w: 0.35, h: 0.35, fontSize: 11, bold: true, color: WHITE, align: "center", valign: "middle", margin: 0 });
    s.addText(t, { x: 0.9, y, w: 8.8, h: 0.55, fontSize: 12, color: "D0E8F8", valign: "middle" });
  });
}

// ─── WRITE FILE ───────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/diabetes-ppt/Diabetes_Mellitus.pptx" })
  .then(() => console.log("SUCCESS"))
  .catch(e => { console.error("ERROR:", e); process.exit(1); });